Joint Commission Journal on Quality and Patient Safety
BACKGROUND: For Ascension Health's Healthcare That Is Safe strategy, Sacred Heart Hospital (SHH) and Columbia St. Mary's (CSM) served as alpha sites to develop strategies to eliminate perioperative adverse events (POAEs). The alpha sites set an interim goal of a 50% reduction of POAEs, then 100%, or elimination of POAEs by July 2008.
The Joint Commission requires health systems to address spiritual care. Research indicates that spirituality is associated with better physical, psychological, and social health and that culturally diverse populations and individuals at end-of-life often request spiritual care. The authors report the results of a consensus conference of 21 executives representing 10 large faith-based health systems who discussed the input, process, and outcomes of a corporate model for spiritual leadership. Specific initiatives are highlighted.
BACKGROUND: Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. AIM: Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. DESIGN: Uncontrolled before-after intervention cluster trial. SETTINGS/PARTICIPANTS: The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme.
Fifty-two patients, who were not considered to be suitable for traditional therapy, were evaluated on their admission (53 admissions) to the Slow Stream Rehabilitation Unit at Greenwich Hospital, and on and after their discharge from hospital, with a minimum follow-up period after discharge from hospital of 13 months. Mobility and the capacity to perform basic self-care activities were assessed by means of a set protocol while traditional rehabilitation therapies were employed.
The authors have submitted a modified technique by which to treat severe cervical insufficiency in gynaecological practice, outside pregnancy. The technique may be used with generosity, since no particular technical problems are involved, and complications are ruled which may otherwise occur, when surgery is applied during pregnancy.